1. Field of the Invention
The present invention relates to a system and method for generating and storing a medical history. More particularly, it relates to a system and method that incorporates the process of taking the medical history using a database to control the system and the storage.
2. Discussion of Related Art
To make an informed diagnosis of a patient's condition, a physician requires an accurate, complete, and up-to-date medical history of the patient. It can be common for a physician or another trained medical professional (e.g., a nurse, nurse practitioner, or physician's assistant) to take a medical history manually and spend significant time questioning the patient and recording the responses. Responses can then be entered into a computer system and stored in a database for later retrieval and review by a medical professional. However, significant time is spent by highly trained medical personnel in obtaining basic information that does not necessarily require their expertise. Furthermore, at each subsequent contact between the patient and a medical professional, the entire medical history must be reviewed. There are no systems for easily determining changes in medical histories or analyzing the significance of such changes. As the costs of health care have increased, the medical industry has sought ways to reduce costs. Therefore, a need exists for a system that can be used to take a medical history without the direct participation of expensive medical personnel. A need further exists for a system that can aid the medical personnel in locating and understanding changes in a medical history of a patient over time.
Some computerized systems are available for patients to enter medical data themselves in response to queries. However, such systems have not yet found widespread acceptance due to limitations in such systems. Typically, a computerized medical history system uses a predetermined set of questions for the patient to answer. Many times, the answers to certain questions require additional information or follow up, which then must be performed by medical personnel. Sometimes, test information is needed in response to questions, or test results require additional questions. Furthermore, such systems do not respond to changing facts. Typically, the entire medical history has to be reset and reviewed by the patient upon every occurrence. These systems lack the ability to determine or analyze the parts of the medical history that have changed. Therefore, a need exists for a computerized system that can accommodate and respond to large variations in questioning systems and test information. Typically, the content and order of medical histories are dependent upon the facility where the medical history is taken, or even the particular person who takes the history. There are no standard formats, questions, or organization. Thus, even if a medical history were obtained from another location, it might not be easily transferable to the new system. This problem is further exacerbated by differences in languages, which prevent even simple translations.
Once a medical history is taken, it is typically stored in a database of the computer system of the medical facility where the history was taken. A disadvantage of this method for storing medical records is that the databases are not easily accessible. The records can be retrieved only by medical professionals within a particular office, facility, or care network. When a patient is “out of network” and has an emergency, the medical personnel treating the patient in that emergency often do not have access to the patient's medical history. Additionally, when a patient has various medical needs and must go to another facility, personnel in that facility may be required to do a complete medical history again. Even if the information could be retrieved by other facilities, there may be additional problems when medical records are in a language other than that of the health care provider, or are stored in an unknown format. Therefore, a need exists for a system that permits simplified access to a medical history for a patient at different locations and different times.
Another issue with computerized medical records relates to the sheer size of the data being stored, especially medical image data. The size of the data being stored can be a limitation when attempting to provide patient data via a mechanism such as a so-called “smart card” that the patient can carry. It would be desirable to store at least some of a patient's medical history in a form that takes up very little memory, while still providing a full range of information about the patient. Therefore, a need exists for a system for storing a medical history with minimal memory requirements.
One proposed solution to improving access to and increasing storage for medical records has been storing of medical records online. As health care has been increasingly computerized and as the Internet has become prevalent as a means of communicating information, the Internet is being used to collect, analyze, and distribute medical data. Online medical history information enables patients and their health care providers to access medical history information such as recent treatments, medical test results, medical images (e.g., X-Ray, CAT Scan, MRI, etc.), family histories, and the like. Despite the advantages of online availability of medical data, there are unresolved issues, including controlling the use of and access to the information and determining ownership of the information. The Congress of the United States has similar concerns with the use of medical record information, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) required Congress to pass requirements for medical record privacy. Thus, there is a need for systems that can provide improved confidentiality of online medical records such as medical histories. Even without online records, privacy is a major concern with many systems. A third-party payor may review a medical history in determining proper treatment, tests, diagnosis, and other matters necessary for authorization of payment. Under known systems, the private medical information of a patient is provided to and reviewed by clerical personnel at the payor. No system exists for providing necessary information for making payment decisions without disclosing private medical records.